Background: Allergic contact dermatitis (ACD) is a Type IV hypersensitivity reaction that can be challenging to diagnose in children due to its resemblance to other dermatologic conditions such as atopic dermatitis.Despite historical beliefs, recent studies show that ACD is prevalent in pediatric populations, with an increasing number of cases reported.Objective: This study aimed to investigate the prevalence of allergic sensitization in children with suspected ACD, identify the most common allergens, and examine the relationship between allergic diseases and patch test positivity. Materials and Methods:A retrospective study was conducted at the Pediatric Allergy and Immunology Clinic between April 2023 and December 2024, including children aged 2-18 years.Patients underwent patch testing using the European standard series and were assessed for demographic data, allergic disease history, and laboratory tests.Results: A total of 99 patients with suspected allergic contact dermatitis (ACD) were evaluated, with a median age of 14 years (IQR: 9-16).Patch test positivity was detected in 58 patients (58.6%), and clinically relevant sensitizations were identified in 32 of them (55.1%).The most commonly affected site was the hand (44%), frequently associated with metal exposure.At least one allergic disease was present in 50.5% of the patients, with atopic dermatitis (34.4%) being the most prevalent.Skin prick test positivity was observed in 28% of the patients, predominantly to pollen (22.2%).The most frequently detected contact allergens were metals (26.8%), particularly nickel sulfate (11.8%). Conclusion:ACD is a common condition in children, with metals and preservatives as the most prevalent allergens.Early diagnosis through patch testing and proactive management of environmental exposures are crucial for improving patient outcomes and reducing the impact of ACD on the quality of life.

Mastocytosis is a rare clonal disease of hematopoietic stem cells characterized by the accumulation of mast cells in the skin (cutaneous mastocytosis, CM) or in multiple organs such as the bone marrow, liver, spleen, and lymph nodes (systemic mastocytosis, SM).In this case report, we present a case of systemic mastocytosis with cutaneous involvement.

Objective: Abnormal immune responses play a fundamental role in coronavirus disease 2019 .Overexpression of proinflammatory cytokines, especially tumor necrosis factor-alpha (TNF-), is considered as one of the important factors in the development of the disease.Several monoclonal antibodies have been proposed to inhibit the function of TNF-.Therefore, this study investigated the possible effects of a biosimilar Adalimumab named CinnoRA , a TNF- inhibitor, on patients with severe COVID-19. Materials and Methods:This randomized clinical trial was conducted on 80 patients infected with severe COVID-19.After confirming the disease, patients were selected with simple random sampling and divided into two groups, including patients receiving subcutaneous injections of 80 mg of adalimumab and standard treatments (case group) and those only treated with standard treatments (control group).The demographic features, clinical symptoms, laboratory findings, and other information were recorded during hospitalization. Results:No patients in the case group required ventilatory support and only one case died due to COVID-19, whereas three cases of the control group needed ventilatory support and died during hospitalization.Although there were differences in the values of peripheral blood oxygen saturation (SpO2), erythrocyte sediment rate (ESR), C-reactive protein (CRP), and hospitalization duration between subjects treated with and without adalimumab, these alterations were not statistically significant. Conclusion:The treatment with adalimumab failed to exert significant changes in clinical and laboratory parameters participating in the recovery and outcome of COVID-19.

The emergence of large language models (LLMs) presents significant opportunities in healthcare and medical education.This study evaluates the performance of LLMs in medical examinations, with a specific focus on allergy, immunology, and related specialties.LLMs have developed the ability to comprehend, interpret, and process language in a manner akin to humans.This advancement raises concerns about their potential role in disciplines like medicine, which require advanced cognitive skills and a deep, specialized knowledge base.Following PRISMA guidelines, our review investigates the performance of LLMs in medical tests, highlighting both their strengths and limitations.We found that LLMs demonstrate higher accuracy on English-language assessments but exhibit significant variation in performance across different medical disciplines.This underscores the need for discipline-specific training and raises ethical considerations regarding challenges in clinical reasoning and visual interpretation.Future research should address linguistic biases, develop specialized protocols, and enhance the capacity of LLMs in immunology and allergy.This study emphasizes the potential of LLMs to transform medical education and advocates for their careful integration to ensure adequate support for healthcare professionals in managing complex allergic and immunological conditions.

Severe asthma (SA) is defined as asthma that is uncontrolled under high-dose ICS+LABA treatment or can only be controlled with this high-dose treatment, with a differential diagnosis from difficult asthma.It has been known that severe asthmatics with poor symptom control were reported as 3.7% (range between 3.6-6.1%).Although SA constitutes a very small proportion of all asthmatics, it causes a significant social and psychological burden on patients and on social reimbursement systems.The Turkish Severe Asthma Program (TSAP) was established by stakeholders that include the Turkish National Society of Allergy and Clinical Immunology (TNSACI), representatives from national severe asthma centers, and those from the pharmaceutical industry to develop standards to diagnose and treat patients with SA and to monitor their treatments at the national level.Here we present the TSAP organization and vision.

Kimura disease (KD) is a rare, chronic, inflammatory disorder of unknown etiology characterized by the development of subcutaneous lymphoid masses, usually in the head and neck region; regional lymphadenopathy; peripheral eosinophilia; and elevated levels of serum IgE.KD has been described in China and Japan as "eosinophilic hyperplastic lymphogranuloma" or "atypical granulation associated with hyperplastic abnormalities in the lymphoid tissue".The precise prevalence and incidence and the pathogenesis of KD are unknown.Trauma, infection, an IgE-mediated hypersensitivity reaction, or autoimmune processes have been postulated as possible causes.In this article, we aimed to present a patient who was investigated with elevated serum total IgE and eosinophils and diagnosed as Kimura disease in the light of the current literature.

Objective: Inborn errors of immunity (IEI) are a diverse group of inherited diseases that affect the innate and adaptive immune systems, leading to symptoms and signs related to infections, autoimmunity, and allergies.There is a remarkable correlation between IEI and endocrinopathies.Our study aimed to retrospectively analyze the clinical, immunological, and endocrine features of our IEI patient group. Materials and Methods:We retrospectively reviewed medical records of IEI patients from our clinic.Results: Our study included 40 patients (23 men, 17 women) with a median age of 37 years (range:24-66).The predominant clinical phenotype observed was primary antibody deficiencies (92.5%).Only two patients had a genetic diagnosis: one with a pathogenic variant in the nuclear factor-kappaB2 deficiency (NFKB2) and another in Wiskott-Aldrich Syndrome (WAS) genes.At diagnosis, only one patient had endocrinopathies, but during the last visit 13 patients (32.5%) developed at least one endocrine pathology, among which thyroid disease was the most common.Thyroid disease was present in 11 patients (four with thyroid nodules, three with primary hypothyroidism, two with primary hypothyroidism and thyroid nodules, one with secondary hypothyroidism, one with Graves' disease).Additionally, adrenal insufficiency was observed in five patients and primary hypoparathyroidism was found in one patient.The patient diagnosed with NFKB2 deficiency was investigated for potential endocrine disorders that could accompany the genetic defect, despite the absence of clinical symptoms.The patient was subsequently diagnosed with central adrenal insufficiency following these investigations.Another patient in our study had primary adrenal insufficiency, primary hypoparathyroidism, thyroid nodule, and chronic mucocutaneous candidiasis.No mutations in the autoimmune regulatory and forkhead box protein P3 genes were detected in the targeted genome sequencing.Further genetic examination was planned for this patient. Conclusion:In our study, endocrinopathy was a frequent comorbidity observed in our IEI patients.We believe that establishing appropriate screening programs for endocrinopathies in IEI patients is crucial to guiding healthcare professionals.